Factors Influencing Provision of Holistic Nursing Care to Patients Admitted in Medical Wards at Kenyatta National Hospital, Kenya

Introduction: In Kenya, most public hospitals offer good nursing care to patients. However, the type of care given does not really focus on the holistic approach to treatment mostly seen within medical wards with patients who appear stable.

Aims: The study is aimed at establishing factors influencing the provision of holistic nursing care to patients admitted in medical wards at KNH, Kenya.

Study Design: A cross-sectional study involving 80 nurses in medical wards taking care of patients selected using simple random sampling from 100 nurses. Quantitative data was collected using structured self-administered questionnaires both closed and open-ended questions using hybrid model comprising of three phases. Theoretical phase, characteristics of holistic care was identified through a review of literature from PubMed and Google Scholar databases. Fieldwork phase, in-depth interviews were conducted with purposely selected nurses and other healthcare workers. Finally, a theoretical description of the concept of holistic care was extracted mixing both quantitative and qualitative approach. Data were analyzed by using SPSS version 20.0.

Results: 51% of respondents were aged between 26-49 years, 65% were females with 94% being Christians. A large number of respondents, 46% had been working for more than 5 years, 10% of them being wards managers. 95% of respondents demonstrated adequacy knowledge concerning holistic nursing care. Factors found to influence the provision of holistic nursing care included shortage of equipment and supplies (97%); workload inwards (77%); interpersonal relations (90%); nature of nursing (80%); management (87%) and patient outcome feedback (57%).

Conclusion: Provision of holistic nursing care was influenced by the nature of nursing care provided and adequacy of resources. The study recommends that the hospital should organize further training opportunities for nurses; ensuring the adequacy of human resource; provide evaluation tools on care provided and implement feedback obtained from evaluation tools.